Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 11156 | Date 20/02/2024 |
| Token No | SM/22-23/14803 20/02/2024 | Serial | 012 |
| Patient Name | Mrs. FARIDA BEGUM.. | Contact No | |
| Address | INDIA JUTE MILL | Age | 40 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||